Anesthesia and analgesia
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Anesthesia and analgesia · Mar 2007
Clinical TrialMinimum alveolar concentration of sevoflurane for laryngeal mask airway removal in anesthetized children.
In children, it is preferable to remove the laryngeal mask airway (LMA) when the patient is still anesthetized. We sought to determine the optimal minimum alveolar concentration of sevoflurane that would allow removal of the LMA in children without airway complications. ⋯ LMA removal may be accomplished without coughing, moving, or any other airway complication at 1.84% end-tidal sevoflurane concentration in 50% of anesthetized children.
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Anesthesia and analgesia · Mar 2007
Hypercapnic hyperventilation shortens emergence time from isoflurane anesthesia.
To shorten emergence time after a procedure using volatile anesthesia, 78% of anesthesiologists recently surveyed used hyperventilation to rapidly clear the anesthetic from the lungs. Hyperventilation has not been universally adapted into clinical practice because it also decreases the Paco2, which decreases cerebral bloodflow and depresses respiratory drive. Adding deadspace to the patient's airway may be a simple and safe method of maintaining a normal or slightly increased Paco2 during hyperventilation. ⋯ The emergence time after isoflurane anesthesia can be shortened significantly by using hyperventilation to rapidly clear the anesthetic from the lungs and CO2 rebreathing to induce hypercapnia during hyperventilation. The device should be considered when it is important to provide a rapid emergence, especially after surgical procedures where a high concentration of the volatile anesthetic was maintained right up to the end of the procedure, or where surgery ends abruptly and without warning.
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Anesthesia and analgesia · Mar 2007
Lung mechanics and histology during sevoflurane anesthesia in a model of chronic allergic asthma.
There are no studies examining the effects of sevoflurane on a chronically inflamed and remodeled airway, such as that found in asthma. In the present study, we sought to define the respiratory effects of sevoflurane in a model of chronic allergic asthma. For this purpose, pulmonary mechanics were studied and lung morphometry analyzed to determine whether the physiological modifications reflected underlying morphological changes. ⋯ Sevoflurane anesthesia acted both at airway level and lung periphery reducing ([DELTA]P1 and [DELTA]P2 pressures, and Est in chronic allergic asthma.
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Anesthesia and analgesia · Mar 2007
The effects of clonidine on postoperative analgesia after peripheral nerve blockade in children.
The effect of clonidine on the duration of sensory blockade after peripheral nerve blockade is controversial. We evaluated the effects of clonidine on the duration of sensory and motor block and analgesia time in children who underwent a variety of peripheral nerve blocks. ⋯ The addition of clonidine to bupivacaine and ropivacaine can extend sensory block by a few hours, and increase the incidence of motor blocks.